Arbitration Offers Long-Term Surprise Medical Billing Solution
At the outbreak of the COVID-19 pandemic earlier this year, Congress rushed to pass legislation waiving fees for patients getting tested for the virus. The intention was, of course, to help to quickly and efficiently flatten the curve and stop the spread of the virus without forcing Americans to pay thousands just for getting tested.
However, for many patients that has simply not been the reality of the situation. As patients have been receiving tests so they know whether to quarantine, more and more are finding themselves stuck with a sizable bill. In fact, estimates indicate that somewhere around 2.4 percent of coronavirus tests result in some sort of bill for the patient. While that may not seem like a lot at first, that could actually amount to hundreds of thousands of Americans receiving surprise medical bills after getting tested.
The problem is unfortunately not limited to COVID-19 testing, either. Every year, people from across the U.S. end up receiving surprise medical bills for any number of treatments after mistakenly seeing a doctor that is outside of their network. If the problem is allowed to continue, unexpected costs will continue to be a major roadblock preventing patients in America from accessing affordable health care.
That is why it’s relieving to see that President Trump has made ending surprise medical billing a top priority for his health care agenda. He has asked Congress to work toward a solution that will finally get this problem under control and allow patients in the U.S. to go to the doctor without the fear of finding out after the fact that the doctor was not covered under their insurance plan.
The best proposal to address this has come from Senator Bill Cassidy (R-LA). The bill he has been working on, called the STOP Surprise Medical Bills Act, uses a system of arbitration to settle disputes between insurers and providers over surprise medical bills. This way, doctors can rest assured that they will receive fair compensation for the treatments they provide, while patients do not have to fret over how they are going to pay their medical bills without exhausting their savings.
In fact, this solution has already proven successful in states like Florida, Texas, and others that have adopted similar arbitration frameworks. In those states, arbitration helped to rein in surprise billing and provide substantial relief for patients.
The STOP Surprise Medical Bills Act’s arbitration system is also far better than other solutions that have been offered up so far, like government rate-setting. Price controls are never good policy, and health care is no different.
Under government rate-setting, big insurance companies would have unprecedented lobbying leverage over rates. They would be able to convince Congress to implement rates that are lower than they should be, giving large insurance providers a leg up over smaller insurers and health care providers, which would in turn force many to shut down. Naturally, this would be particularly disastrous in rural communities, where these smaller providers are the only treatment options within a reasonable distance.
That’s why I trust that Senate Majority Leader Mitch McConnell will reject any government rate-setting proposals and instead will bring the STOP Surprise Medical Bills Act before the Senate for a vote. It is an important piece of legislation that offers the best path forward for America’s patients and health care providers.
In the midst of a crisis as significant as the COVID-19 epidemic, it is absolutely critical that Americans are able to access health care without worrying about surprise medical bills. With the STOP Surprise Medical Bills Act, Congress can provide that relief while also securing a long-term fix for one of American health care’s biggest problems.
Ted Alexander is a State Senator Representing North Carolina’s 44th District
